The effect of pulmonary isolation on the initiation and sustenance of atrial fibrillation induced in left atrial, volume-load model

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Effect of pulmonary isolation on the initiation and sustenance of atrial fibrillation was studied in canine left atrial volume-load model. A shunt was made between the left subclavian artery and the left pulmonary artery in mongrel dogs. All the animals exhibited severe heart failure postoperatively. Some animals died of severe heart failure. Rapid pacing at the left atrial appendage was initiated one week after the shunt surgery. The animals survived for 4 weeks were subjected to the pulmonary vein mapping study.Continuous atrial fibrillation was observed in all animals. The cycle length of the left atrial electrograms was shorter than that of the right atrial electrograms. The cycle length progressively shortened during the 4 weeks. Atrial activation maps during atrial fibrillation showed repetitive activation originated from the right and left superior pulmonary veins and fibrillatory conduction to the right atrium. Pulmonary vein isolation was performed by means of bipolar radiofrequency ablation device. Atrial fibrillation was not terminated in any animals.In addition to the repetitive activation in the pulmonary veins, atrial reentrant activations or non-pulmonary vein abnormal activations might have played a role in the sustenance of atrial fibrillation in the left atrial volume-load model.